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Creation and Implementation of a Nurse Practitioner Student Escape Room
Sara Arn, MSN, CRNP, AGPCNP-BC
Introduction
Educational escape rooms have been gaining popularity in nursing institutions over the past few years. The current literature focuses on the creation, implementation, and benefit of escape rooms for undergraduate nursing students. This poster presentation describes the creation and implementation of an educational escape room targeted to the experiences and skills of advanced practice nursing students enrolled in nurse practitioner programs.
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Enhancing Digital Health Equity: A Personalized Approach for Spanish-Speaking Patients
Marissa Witmer; Julianna LeNoir, MPH; Angela Gerolamo, PhD, CRNP, PMHNP; Akshay Krishnan; David Rigas; and Kristin L. Rising, MD, MSHP
Background
Limited English Proficiency (LEP) is a barrier among Hispanic communities in accessing digital health tools including patient portals.1
Patient portals provide patients with access to their electronic medical records. With portals, patients can schedule visits, message providers, check test results, and order medication refills, among other tasks.
Portal use has been shown to help patients better manage chronic diseases, enhance doctor-patient relationships, improve patient understanding and awareness of health status, and increase adherence to therapy.2
Despite interest in using patient portals, Spanish-speaking patients often struggle to use them due to low digital literacy.3
Provision of personalized digital support during hospitalization may be an option for improving use of MyChart (the Epic patient portal used at Thomas Jefferson University Hospital) among patients. (See Figure 1 for MyChart Spanish Interface)
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The Impact of Role Perception Gaps Among Nurses: An Integrative Review
Anita Fennessey, DrNP, RN, CNE
Background & Significance
- Inadequate communication has consistently been indicated as a contributor to adverse events in all areas of healthcare (Paltved et al, 2017).
- Factors related to individual, team, work environment, organizational and institutional aspects have also been shown to influence patient safety, with increased chances of causing patient harm (Rezende da Silva dos Santos, Campos & Celestino da Silva, 2018).
- Efficient communication among healthcare members is considered a contributing element in promoting a culture of safety (Rezende da Silva dos Santos, Campos & Celestino da Silva, 2018).
- Errors in communication can compromise continuity of care and place patient safety at risk. These errors have been shown as contributors to the occurrence of adverse events (Rezende da Silva dos Santos, Campos & Celestino da Silva, 2018).
- Relational Coordination Theory provided a framework correlating how superior communication reinforced by high-quality associations such as shared goals and mutual trust and respect can enable nurses to successfully coordinate care leading to positive patient outcomes (Havens, Vasey, Gittell & Lin, 2020).
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Acute Inpatient Stabilization Study Primary Stakeholders Evaluation
Tara Flood, DNP, RN, CBC
Background
The current opioid crisis is a significant public health issue in the United States, especially amongst women of reproductive age. In the last two decades, the rate of opioid use disorder (OUD) in pregnant women has quadrupled. Women with substance use disorders (SUD) experience more sociodemographic and health disadvantages, pre-existing health conditions, and co-morbid psychiatric diagnoses than their counterparts without SUDs. They are also more likely to experience emergency department visits and hospitalizations during the antenatal period and less likely to utilize prenatal healthcare services.
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Addressing Inpatient Substance Use Stigma and Bias: An Examination to Support Training for Healthcare Professionals
Tara Flood, DNP, RN, CBC
Background
The current opioid crisis is a significant public health issue in the United States, especially amongst women of reproductive age. In the last two decades, the rate of opioid use disorder (OUD) in pregnant women has quadrupled. Women with substance use disorders (SUD) experience more sociodemographic and health disadvantages, pre-existing health conditions, and co-morbid psychiatric diagnoses than their counterparts without SUDs. They are also more likely to experience emergency department visits and hospitalizations during the antenatal period and less likely to utilize prenatal healthcare services.
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Opioid Use Disorder (OUD) and Neonatal Abstinence Syndrome (NAS) Education in an Undergraduate Nursing Program
Tara Flood, DNP, RN, CBC
Background
In 2018 the American Academy of Nursing urged all nursing schools to adopt curriculum to address the opioid epidemic, although few programs have begun this work.
Minimal background training in nursing school is focused on caring for patients with Opiate use disorder ( OUD) and Neonatal Abstinence Syndrome (NAS) leaving nurses to develop the necessary skills for optimal patient engagement to be formulated in practice. An undergraduate nursing program in an urban setting developed OUD and NAS education into their curriculum.
Undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder.
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Reflecting on Student and Novice Nurses’ Clinical Decision-Making at the Bedside: Considering a Gen Z Influence
Teresa Wenner, EdD, MSN, RN-BC, CNE; Karen Waterfall, MSN, RN-CCRN; Mary Hanson-Zalot, EdD, MSN, RN, CNE; and Julia Ward, PhD, RN
Introduction: The relationship between nurses’ decision-making and healthcare outcomes is a high priority in nursing research today. Prior studies and nursing theory have indicated that students and novice nurses rely primarily on formal procedures and concrete evidence to make clinical decisions, but with the passage of time and through meaningful experience, decision-making becomes more intuitive in nature. Increased awareness of the decision-making processes among students and novice nurses is needed to improve health outcomes.
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The Extent of Disability Education in Three Levels of Nursing Education: A Descriptive Quantitative Stud
Ksenia Zukowsky, PhD, CRNP, NNP; Julia Ward, RN, PhD; and Ruth Wittmann-Price, PhD, RN, ANEF, FAAN
Purpose
- This quasi-experimental research project, completed by a Qualtrics survey, assessed the knowledge and confidence of baccalaureate, masters, and Doctor of Nursing Practice (DNP) nursing students’ about caring for People With Disabilities (PWD).
- Participants completed a Qualtrics survey to assessed the knowledge and confidence about caring for People With Disabilities.
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Implicit Bias Training in Student Registered Nurse Anesthetists
Iteona Roundtree, BSN, RN, SRNA and Jodi-Ann Smith, BSN, RN, SRNA
Research Question:
In first-year DNP student registered nurse anesthetists (SRNAs), will an implicit bias training activity increase self-awareness and knowledge of implicit bias and its implications in healthcare?
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The Effect of a Didactic Educational Program with Practical Application on Nursing Knowledge and Empowerment in Antibiotic Stewardship
Eleanor Fitzpatrick, RN, MSN, AG-CNS, ACNP, CCRN
- Antimicrobial use is a crucial element of patient care but their overuse and misuse have detrimental effects including the growing problem of antimicrobial resistance (AMR).
- Nurse empowerment and engagement has resulted in improvements in many quality initiatives including enhanced patient safety in the areas of Central Line Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infections (CAUTI) and pressure injuries (Carter, 2016).
- Enhancing nurse empowerment in AS may be effective in reducing antibiotic misuse.
- The purpose of this study is to implement an educational program engaging nurses in AS activities and determining the effect of this educational intervention on the knowledge and empowerment of staff nurses.
- The theoretical framework for this study is the work of Donabedian (2005) on the quality of health care which is divided into structure, process and outcome measures
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Felty Syndrome
Dorothea Frederick, DNP, FNP-C
Take home point: It is important to remember that the diagnosis of FS may be masked in patients who present with infection, since active bacterial infection raises the WBC count to normal or slightly elevated – the neutropenia reappears shortly after successful treatment (Kay, 2017).
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Experiential Learning and Injury Prevention: A Win-Win
Christine McKeever, MSN, RN; Julia Ward, PhD, RN; Anita Fennessey, DRNP, RN, CNE; and Kathryn M. Shaffer, EdD, RN, MSN, CNE
Purpose
Experiential learning opportunities help prepare students for patients in crisis management
Harm reduction by ensuring students become certified in the Stop the Bleed Campaign & Opioid Overdose Narcan Prevention
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Assessing Knowledge and Perspectives of Pediatric Nurse Practitioners Students After Receiving Trauma Informed Care Training
Laura Roettger, PhD, CRNP and Jane Tobias, DNP, CRNP
PNP students showed improved understanding and comfort level in caring and managing children exposed to adverse childhood experiences following two TIC learning sessions.
Future Implications
- TIC education should be integrated into curriculum.
- Interprofessional collaboration among students improves knowledge base and understanding of TIC
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Reflux, Apnea and the Impact on Discharge
Michele Savin, DNP, NNP-BC; Kaitlin Kenaley, MD; Maureen Moffet, MSN; and Rula Nassar, MD
Decisions made about timing of discharge can be subjective. Definitions of significant bradycardia are multiple, and interventions are variable.
This necessitates an informed discussion with parents about the natural course of apnea, bradycardia and reflux.
The physiology of gastroesophageal reflux and respiratory control have intermingled confounding variables.
Critical thinking is required to educate and support families, however a paucity of research exists. Risks and benefits of pharmacologic and nonpharmacologic interventions should be evaluated.
Nurses need increased confidence in understanding how to approach the preterm infant with apnea and/or reflux as well as how to interact with families to support discharge planning.
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Rotating Shifts vs. Fixed Schedules
Sara Vallett, BA, BSN, RN and Dilek Reisoglu, BS, BSN, RN
Purpose
- This EBP project seeks to examine the literature and nurses’ perceptions related to rotating shifts, especially the impact of quick returns on nurses and possible solutions.
- Nurses struggle to manage rotating shifts with quick turnaround between shifts. Quick returns defined as returning to work a different shift within 24 hrs
PICO question: What effect does rotating shifts with (quick returns) have on clinical nurses?
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Understanding Patient Uncertainty as a Driver of Emergency Department Utilization: A Concept Mapping Approach
Angela Gerolamo, PhD, RN; Shannon Doyle, MPH; Rhea E. Powell, MD, MPH; Amanda M.B. Doty, MS; Marianna LaNoue, PhD; and Kristin L. Rising, MD, MSHP
Background and Purpose
- Most previous research regarding factors associated with increased risk of emergency department (ED) use has been done via retrospective review of medical records rather than obtaining patients’ perspectives.
- Recent research identified patient uncertainty related to symptoms as a primary motivator for seeking ED care, and ongoing uncertainty at the time of ED discharge as an unmet need (Rising et al. 2015; Rising, Hudgins, Reigle, Hollander, & Carr 2016).
- While providers have limited ability to influence many factors identified by retrospective medical record review (e.g. financial concerns), patient uncertainty can be addressed by providers directly. To do so we must first define domains of uncertainty that patients experience in order to inform targeted interventions to address patient uncertainty.
- The objective of this research was to engage patients through group concept mapping (GCM) to conceptualize the domains of uncertainty that contribute to decisions to seek care in the ED.
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Coordinating Care and Managing Transitions for Individuals with Complex Care Needs Using the CCTM RN Model
Sheila Haas, PhD, RN, FAAN; Beth Swan, PhD, CRNP, FAAN; and Traci Haynes, MSN, RN, CEN, CCCTM
Objectives
- Discuss demand for care transition management for individuals with complex care needs across the care continuum
- Describe development of the Care Coordination and Transition Management (CCTM) dimensions and competencies
- Discuss challenges, future directions, and outcomes of the CCTM RN Model in managing care transitions for individuals with complex care needs
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Development of a Disaster Preparedness Interprofessional Education (IPE) Program for Health Profession Students
Edward Jasper, MD; Mary Bouchaud, PhD, MSN, CNS, RN, CRRN; Dale Berg, MD; Katherine W Berg, MD; and John F McAna, PhD
- Despite numerous attacks and threats both in the US and around the world, there is no standardized disaster preparedness curriculum for health profession students
- This project is the development and implementation of an IPE disaster preparedness curriculum with both a mandatory component and additional training as an elective at Thomas Jefferson University (TJU) in Philadelphia
- Upon completion of the elective component, students are Federal Emergency Management Agency (FEMA) Hospital Emergency Response Team (HERT) certified and become part of the hospital’s disaster response and decontamination team
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Refusing to Let the Dust Settle: Creative Evaluation of a Concept-Based Curriculum
Jeannette Kates, PhD, GNP-BC, RN; Mary Hanson-Zalot, EdD, RN; Julia Ward, PhD, RN; Jamie Smith, MSN, RN, CCRN; and Valerie Clary-Muronda, PhD, MSN-Ed, RN
Concept-based curricula are being implemented in nursing education as a means to shift the emphasis from content to an emphasis on concepts and conceptual learning (Giddens & Brady, 2007). This paradigm shift requires concomitant changes in how faculty teach and how students learn. In concept-based curricula, teachers use student-centered learning activities, such as case studies, questions, or problems to engage students in active learning (Giddens, Caputi, & Rodgers, 2015).
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Navigating Health Care Transition: An Exploration into the Experiences of Parents and their Adolescents with Special Health Care Needs Utilizing a Transitional Care Service
Jane Tobias, DNP, CRNP
Abstract
Adolescents with special health care needs encounter barriers and challenges during transition to adult health care that have the potential to impact health outcomes and satisfaction with the experience. The use of transitional care services can provide resources and support throughout the transition process to the adolescent and their parent/caregiver. This descriptive survey study was conducted to evaluate adolescent and/or parent/caregiver satisfaction with the transitional care services provided by an urban, academic, pediatric health care facility. Nineteen of 39 (49%) eligible participants completed the survey. Findings indicate that adolescents and their parent/caregiver were satisfied with the resources and support offered by a transitional care service and experienced positive health outcomes, reinforcing the need for collaboration between pediatrics and adult care providers. Transition of care barriers/facilitators included: concerns with the transition, making the connection, and facilitating the transition.
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Prisons as Learning Environments for Nursing and Public Health Practice
Mary Bouchaud, PhD, RN and Madeline Brooks
Background:
Challenges in Securing Community Nursing Rotation Sites Eighteen years of providing clinical placement for Bachelor of Science in Nursing (BSN) students has demonstrated that community-based educational opportunities are shrinking due to:
•Increased regulatory requirements
•Competing numbers of nursing schools
•Increasing student enrollment
•Decreasing availability of community resources capable and willing to precept students
These issues present challenges to preparing students for nursing practice. A college of nursing at an urban, academic health center found a solution by working with unexpected partners – maximum security prisons and juvenile detention centers.
A Novel Solution: Partnerships with Prisons
Several factors make prisons an ideal learning environment for nursing students. Prisons serve as microcosms of society, reflecting social determinants of health within confined communities. They allow students to work alongside interprofessional teams experienced in correctional health, mental/behavioral health, infection control, and community health. There is ample opportunity for individual assessment and patient education, as well as population-based care. Finally, working with the diverse inmate population promotes cultural awareness and sensitivity.
Poster presented at:
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Community Nursing: Health Care Behind Closed Doors
Mary Bouchaud, PhD, RN and Mary Mangiaracina, MSN, RN, 2009 NLN
Focus of nursing education in the 21st century is to teach students how to work with individuals & families within a community setting & to develop skills in providing nursing care that stresses community as the client.
The expectation of the APHA is that BSN students will be educationally prepared to work with & improve the health of individuals, families, & diverse populations within the community.
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Looking beyond the traditional: integrating a new curriculum design into an immersion practicum evaluation tool
Denise Brown, MSN, RNC-OB; Kathleen D. Black, PhD, RNC-OB; Maureen Fitzgerald, MSN, RNC-NIC; Tara Flood, MSN, CBC; Maureen Kane, MSN, RN, CEN; and Laura Roettger, MSN, CPNP-PC
Abstract
Changes in health care delivery and recent reports from the Institute of Medicine (IOM, 2010) call for nurse educators to reconstruct the way they prepare nursing students for practice in the 21st century. Health care delivery continues to shift from the acute care to outpatient and transitional settings, therefore faculty must assure that graduates are prepared to practice in those environments. In order to address these changes, the Jefferson College of Nursing at Thomas Jefferson University embarked on a mission to redesign their undergraduate curriculum. The new clinical courses, now referred to as Immersion Practicums, were designed to allow students the opportunity to provide care in more diverse community and transitional settings, as well as in acute care facilities. Since the immersions are different from the traditional clinical experience, faculty recognized the need to change the clinical evaluation tool. The purpose of this poster is to describe the process used to develop the immersion evaluation tool, the challenges faculty faced, and the lessons learned.
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Perceptions of Accelerated Bachelor of Science in Nursing Program Graduates Regarding Andragogical Practices Employed by Faculty
Mary Hanson-Zalot, EdD, MSN, RN, AOCN, CNE
Abstract
This research study was designed to examine accelerated, second-degree prelicensure baccalaureate graduates’ perceptions of the andragogical practices employed by faculty that prepared students best to begin practice as entry level professional nurses. Through listening to the voices of graduates an emic perspective of the perceptions of the second-degree graduates emerged. Six key themes were identified related to the educational experience.
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Treatment-Related Decisional Conflict, Quality of Life, and Comorbid Illness in Older Adults with Cancer
Jeannette Kates, PhD, MSN, GNP-BC
As the aging population in the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults are confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. In their current research agenda, the Oncology Nursing Society identified the need for research related to multiple comorbidities in older adults with cancer. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer. Oncology nurses recruited a sample size of 200 for this study from outpatient medical oncology, radiation oncology, and palliative care practices. Using an anonymous survey method, participants completed three psychometrically-sound instruments, including the Decisional Conflict Scale, Self-Administered Comorbidity Questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Bivariate relationships existed between increased levels of decisional conflict and increased quality of life (p = .009) and quality of life and comorbidity (p = .001). All six regression models achieved significance (p < .001). Statistically significant relationships were identified in each of the six regression models. Positive relationships existed between decisional conflict and financial problems, physical function, and global health status/quality of life. Increased emotional function may be predictive of decreased decisional conflict in all of the regression models. Other negative relationships existed between decisional conflict and cognitive function, diarrhea, spiritual support, insomnia, year diagnosed, fatigue, and nausea/vomiting. With their focus on patient-centered care, oncology nurses are a crucial component of the multidisciplinary cancer team that can empower older cancer patients to communicate their values and preferences regarding cancer treatment. Additionally, this study underscores the importance of oncology nurses being prepared to provide high-quality care to geriatric patients with multiple comorbidities. Given the paucity of research on the impact of cancer and its treatment on older adults, there are no published studies that address all of these variables. In light of the regression analyses, further research is needed with regard to emotional function, spiritual support, and symptom management in the setting of decision making in older adults with cancer.
Poster presented at: Oncology Nursing Society 42nd Annual Congress in Denver, CO
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